肺结核患者混合感染其他病原体的研究进展

doi:10.19982/j.issn.1000-6621.20240312

摘要/Abstract

摘要：

结核病是中国面临的重要公共卫生问题之一,肺结核是其最常见表现形式。近年来,随着对肺结核认识的深入及分离培养技术的发展,肺结核并发其他病原体感染的检出率不断增高。混合感染其他病原体是肺结核的重要并发症,与结核分枝杆菌的侵袭性和耐药性密切相关。然而,混合感染的病原体种类复杂,目前,仍缺乏足够的认识,是临床抗结核治疗中的难点。笔者对近年来肺结核混合感染其他病原体的相关研究进行综述,对其他呼吸道致病细菌、真菌、病毒、非结核分枝杆菌、人类免疫缺陷病毒等几种常见的混合感染病原体类型进行重点讨论,为肺结核混合感染其他病原体的临床诊疗提供参考。

关键词: 结核,肺, 重叠感染, 综述文献(主题)

Abstract:

Tuberculosis (TB) is one of the major public health concerns in China, with pulmonary TB being its most prevalent clinical presentation. In recent years, the detection rate of co-infections involving pulmonary TB and other pathogens has significantly increased, driven by a deeper understanding of TB and advancements in isolation and culture techniques. Co-infection with other pathogens is a critical complication of pulmonary TB, closely associated with the invasiveness and drug resistance of Mycobacterium tuberculosis. However, the complexity of pathogens involved in co-infections remains insufficiently understood, posing a considerable challenge in the clinical management of TB. The authors provide an overview of recent studies on co-infections with pulmonary TB, with a focus on common co-infecting pathogens, such as other respiratory bacteria, fungi, viruses, non-tuberculous mycobacteria, and the human immunodeficiency virus. The discussion aims to offer insights into the clinical diagnosis and treatment of TB co-infections, serving as a reference for improved patient management.

Key words: Tuberculosis, pulmonary, Superinfection, Review literature as topic

中图分类号:

R521

何静, 张忠法. 肺结核患者混合感染其他病原体的研究进展[J]. 中国防痨杂志, 2024, 46(12): 1566-1572. doi: 10.19982/j.issn.1000-6621.20240312

He Jing, Zhang Zhongfa. Research progress on mixed infection in pulmonary tuberculosis patients[J]. Chinese Journal of Antituberculosis, 2024, 46(12): 1566-1572. doi: 10.19982/j.issn.1000-6621.20240312

图/表 1

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研究者	国家	菌株数量	优势菌种及其所占比例
Langbang等^[5]	印度	50	金黄色葡萄球菌(32%,16/50) 铜绿假单胞菌(16%,8/50)
Udeani等^[6]	尼日利亚	119	金黄色葡萄球菌(40.3%,48/119) 化脓性链球菌(32.8%,39/119)
Iliyasu等^[7]	尼日利亚	141	肺炎链球菌(44.7%,63/141) 大肠埃希菌(18.4%,26/141)
Attia等^[8]	柬埔寨	13	肺炎克雷伯杆菌(46%,6/13) 铜绿假单胞菌(23%,3/13)
王东萍等^[10]	中国	110	肺炎克雷伯杆菌(13.6%,15/110) 鲍曼不动杆菌(11.8%,13/110)
李红艳等^[11]	中国	847	铜绿假单胞菌(33.2%,281/847) 肺炎克雷伯杆菌(22.6%,191/847)
杨丽梅等^[12]	中国	413	铜绿假单胞菌(22.3%,92/413) 肺炎克雷伯杆菌(14.8%,61/413)
Aldriwesh等^[16]	沙特阿拉伯	84	铜绿假单胞菌(36.9%,31/84) 肺炎克雷伯杆菌(26.2%,22/84)
陈影影等^[17]	中国	161	肺炎克雷伯杆菌(26.1%,42/161) 阴沟肠杆菌(18.6%,30/161)